Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)

Forms and Documents

Document Name	Status
Form CMS-10250 Hospital Outpatient Quality Reporting CY 2016 - CY 2018 Form and Instruction	Modified
CMS-10250 Supporting Statement Part B CY 2017 OPPS-ASC Proposed Rule.doc Supporting Statement B	2017-06-12
CMS-10250 SS Part A HOQR CY 2017 OPPS - Passback_6.7.2017.doc Supporting Statement A	2017-06-12

IC Document Collections

IC ID	Document Title	Status
217995	Hospital Outpatient Quality Reporting CY 2016 - CY 2018 Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1109	ICR Reference No: 201611-0938-018
Status: Historical Active	Previous ICR Reference No: 201607-0938-011
Agency/Subagency: HHS/CMS	Agency Tracking No: 21225
Title: Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/15/2017
	Date Received in OIRA: 11/30/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2018	36 Months From Approved	10/31/2017
Responses	2,331,986	0	2,331,486
Time Burden (Hours)	3,444,227	0	3,056,717
Cost Burden (Dollars)	0	0	0

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Abstract: Section 109(a) of the Tax Relief and Health Care Act of 2006 (TRHCA) (Pub. L. 109-432) amended section 1833(t) of the Social Security Act by adding a new subsection (17) that affects the payment rate update applicable to Outpatient Prospective Payment System (OPPS) payments for services furnished by hospitals in outpatient settings on or after January 1, 2009. Section 1833(t)(17)(A) of the Act, which applies to hospitals as defined under section 1886(d)(1)(B) of the Act, requires that hospitals that fail to report data required for quality measures selected by the Secretary in the form and manner required by the Secretary under section 1833(t)(17)(B) of the Act will incur a reduction in their annual payment update (APU) factor to the hospital outpatient department fee schedule by 2.0 percentage points. Hospital OQR Program payment determinations are made based on Hospital OQR Program quality measure data reported and supporting forms submitted by hospitals as specified through rulemaking. To reduce burden, a variety of different data collection mechanisms are employed, with every consideration taken to employ existing data and data collection systems.

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Authorizing Statute(s): PL: Pub.L. 109 - 432 109(a) Name of Law: Quality reporting for hospital outpatient services and ambulatory surgical center services
   PL: Pub.L. 111 - 148 3014 Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AS82	Final or interim final rulemaking	81 FR 79562	11/14/2016

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 45603	07/14/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 79562	11/14/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Hospital Outpatient Quality Reporting CY 2016 - CY 2018	CMS-10250, CMS-10250	Notice of Participation Form ,   Validation Review for Reconsideration Request

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,331,986	2,331,486	0	500	0	0
Annual Time Burden (Hours)	3,444,227	3,056,717	0	387,510	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There is a burden increase of 387,510 hours (3,444,227 hours - 3,056,717 hours).

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Annual Cost to Federal Government: $10,050,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/30/2016

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